Heart disease is often seen as a disease of the elderly and middle-aged, as well as obese people.
But while the average person is diagnosed in their 60s, doctors say the warning signs can appear decades in advance.
However, the symptoms can begin subtly, making them more likely to be missed or ignored.
According to Dr. Dheepak Bhatt, a cardiologist at Mount Sinai, common problems such as anxiety, fatigue and pain in the extremities could be a sign of a deeper problem.
These symptoms will be harmless to the vast majority of people, but if a person feels them in addition to chest tightness or has a family history of heart disease, they may want to seek medical attention.
He said behaviors such as quitting smoking or vaping, being more active, eating healthier, and even avoiding marijuana can reduce a young person’s risk of heart disease.
The condition is the leading killer of Americans. It is responsible for about 700,000 deaths each year.
An estimated eight percent of American men and four percent of women suffer from the condition.
While everyone feels a little anxious, that feeling of unease that you carry around with you can be a sign of a heart problem in some cases.
Anxiety and heart disease have a symbiotic relationship with each other. Being constantly tense puts a strain on the body and over time damages the heart.
Someone who suffers from heart disease is also more likely to suffer from anxiety.
“It’s hard to know which came first. It’s a chicken-or-egg situation,” says Dr Bhatt.
Problems with a person’s heart, such as palpitations, an irregular heartbeat, or just general pain, cause stress in people, leading to anxiety.
This, in turn, makes a person’s heart disease symptoms even worse.
A 2015 study by Harvard University researchers found that people with anxiety who suffered from coronary artery disease (CAD) were more likely to die.
Their risk increased by as much as 21 percent.
However, the effect of the fear on the heart is not the only factor involved.
People suffering from the mental illness are less likely to seek medical help and more likely to eat a diet high in cholesterol, experts say.
As a result, their symptoms go untreated and are even aggravated by their daily food intake.
It is believed that one in five American adults suffer from anxiety every year – even though many go undiagnosed or receive no treatment for the condition.
Anxiety sufferers in the US are more likely to be younger — and most common in those under 45 — and more likely to be female.
While it may be hard to imagine that pain in your legs has anything to do with your heart, a tingling sensation in your extremities could indicate deeper problems.
Numbness, pain and tingling in the legs can be a sign that there is not enough blood circulating in the extremities of the body.
Known as peripheral arterial disease (PAD), the condition occurs when arteries in the legs become narrow and blocked by the buildup of plaque.
This can happen for a variety of reasons, such as a poor diet high in sodium or cholesterol, too much stress, smoking, or obesity.
There are five arteries in a person’s legs and each plays a vital role in circulating blood to the farthest regions of the body and then back to the heart.
In the thigh, a person has his femoral and popliteal arteries. The anterior tibial, posterior tibial, and peroneal arteries are all located in the lower leg, around the shins and calves.
When these arteries become clogged — preventing enough blood from flowing to the lower parts of the body — the tissue is damaged.
In most severe cases, obstructed blood flow can lead to amputation. The American Heart Association warns that 54 percent of amputations in the US are related to PAD.
This symptom is often overlooked, says Dr. Bhatt. Leg pain can be a result of being out of shape or an injury, and doctors will rarely make the connection between the legs and heart disease.
“Even doctors don’t think about it,” he said.
If a person gets leg pain, numbness, or tingling when walking, and it suddenly stops when they rest for a while, Dr. Bhatt says it may be time to see a doctor.
These could also be signs of a heart attack or stroke, Dr. Bhatt explains.
“Numbness or weakness of an arm or leg can be a symptom of a stroke,” he said.
People suffering from a heart attack may also first feel pain in their arm – usually the left arm – along with a tightness in the chest.
Another link that many people may not instinctively make is stomach and digestive pain.
People with heart disease often have sudden and short-lasting abdominal pain at first. As their cardiovascular condition worsens, their gastrointestinal problems will become more common.
Sudden and sharp pain will occur, usually in the upper right part of a person’s stomach.
This can be caused by intestinal angina, which occurs when not enough blood reaches the colon.
People suffering from the condition will often experience pain within an hour of eating a meal. In addition to the sharp pain, they may also experience diarrhea, nausea, and vomiting.
Many who suffer from intestinal angina will also lose significant weight over time, as they will instinctively eat smaller and fewer meals to avoid the pain.
Restricted blood flow can also be caused by clotting in the arteries of the stomach.
Called intestinal ischemia, the clotting can significantly reduce blood flow to a person’s small intestine.
These clots often form as a result of an irregular or rapid heartbeat. In addition to abdominal pain, it can also lead to a stroke.
Both conditions may appear as nausea at first, before escalating into the more serious, noticeable symptoms.
Some people, and maybe even doctors, might write the problems off as heartburn or some other digestive problem, not realizing that it is actually a serious heart condition.
Dr. Dheepak Bhatt, a cardiologist at Mount Sinai, warned that many young people can make the fatal mistake of overlooking early signs of heart problems
While everyone feels tired from time to time, intense fatigue can be a sign that there is a problem with your heart.
“Fatigue is a tough one,” Dr Bhatt said.
‘It’s a very non-specific symptom. Most fatigue is not due to heart disease, maybe just a bad night’s sleep.’
But, he explains, when the blood can’t circulate enough blood to vital organs, a person will feel tired.
“If the heart isn’t pumping properly, that blood and oxygen won’t get to the vital organs,” he continued.
This can cause numerous problems. Not enough blood reaching the lungs can prevent them from taking in enough oxygen.
When the kidney doesn’t get enough blood, it will have a hard time removing waste products from the body.
If not enough blood reaches the liver, the tissue cells in the organ will die and the organ can fail.
One of the first signs of any of these is fatigue. While fatigue can be caused by a myriad of issues on any given day, doctors advise people suffering from chronic fatigue to seek medical attention.
Excessive sweating is a bizarre but common symptom of heart problems.
People with cardiovascular disease often sweat because their body has to work harder to pump blood.
The sweating also keeps the body temperature down, reducing the strain on the heart.
Sweating also removes excess fluid from the body, reducing the kidneys’ workload in cleaning fluids in the body.
If the kidneys are having trouble performing their duties due to heart failure, sweating can help keep the vital organs running.
Dr. Bhatt also says the body might realize it’s suffering from a problem and try to fix it.
“(It could be) that the brain and different aspects of the nervous system activate circuits because they know something is wrong,” he explained.
He also said that sudden profuse sweating, especially when a person is not participating in physical activity, could be one of the first signs of a heart attack.